Press release

CMS seeks recommendations that allow Americans to purchase health insurance across state lines

CMS seeks recommendations that allow Americans to purchase health insurance across state linesAdministration continues efforts to increase consumer choice, promote competition and drive down prices in the health insurance market

The Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) today that solicits recommendations on how to eliminate regulatory, operational and financial barriers to enhance issuers’ ability to sell health insurance coverage across state lines. This announcement builds on President Trump’s October 12, 2017 Executive Order, “Promoting Healthcare Choice and Competition Across the United States,” which intends to provide Americans relief from rising premiums by increasing consumer choice and competition.

The President’s Executive Order specifically instructs the Administration to facilitate the purchase of health insurance coverage across state lines. As a direct result, CMS is issuing this RFI to increase consumer choice. The RFI process allows CMS to obtain valuable feedback from the public and collect ideas on how to change the existing system. In particular, CMS is interested in feedback on how states can take advantage of Section 1333 of the Patient Protection and Affordable Care Act, which provides for the establishment of a regulatory framework that allows two or more states to enter into a Health Care Choice Compact to facilitate the sale of health insurance coverage across state lines. CMS is primarily looking for input on how the agency can expand access to health insurance coverage across state lines, effectively operationalize the sale of health insurance coverage across state lines, and understand the financial impacts of selling health insurance coverage across state lines.

“Americans are in desperate need of more affordable health insurance options,” said CMS Administrator Seema Verma. “Eliminating the barriers to selling health insurance coverage across state lines could help provide access to a more competitive and affordable health insurance market. We are looking for information and ideas from the public on how to create a more dynamic health insurance market with more insurers participating and competing to meet the needs of the American people just like we see in markets for so many other products and services that enhance our daily lives.”

The Trump Administration has made expanding choice and affordability in the health insurance market a key priority. Average individual market premiums available through the Exchange more than doubled from 2013 to 2017, and half of U.S. counties had only one issuer during the 2018 plan year. While average premiums dropped slightly and issuer participation increased this year, premiums remain far too high and a substantial portion of counties continue to have just one issuer. Expanding the sale of health insurance coverage across state lines could provide more options to people with access to just one issuer and give them a new opportunity to pick a plan that better meets their needs and lowers their cost.